HomeMy WebLinkAboutZ-34846 FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 34846 Date: 02/23/11
THIS CERTIFIES that the building DWELLING
Location of Property 1020 NEW SUFFOLK AVE MATTITUCK
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 114 Block 0012 Lot 016.001
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUMBER Z- 34846 dated FEBRUARY 23, 2011
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is ONE FAMILY DWELLING.*
The certificate is issued to GARY H ROSE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
tho ized dignature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 1020 NEW SUFFOLK AVE MATTITUCK
SUBDIVISION: MAP NO.: LOT (S)
NAME OF OWNER (S): GARY H ROSE
OCCUPANCY: ONE FAMILY DWELLING GARY H ROSE
ADMITTED BY: GARY ROSE ACCOMPANIED BY:
KEY AVAILABLE: SUFF_ CO_ TAX MAP NO.: 114.-12-1G.1
SOURCE OF REQUEST: CAROL RAFFE DATE: 02/23/11
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.0 # EXITS: 3
FOUNDATION: CONCRETE CELLAR: 80% CRAWL SPACE: 20%
TOTAL ROOMS: 1ST FLR_: 5 2ND FLR.: 0 3RD FIR.: 0
BATHROOM(S): 2.0 TOILET ROOM(S): 0.0 UTILITY ROOM(S):
PORCH TYPE: DECK TYPE: PATIO TYPE:
BREE23?K&Y: FIREPLACE: 1 GARAGE:
DOMESTIC HOTWATER: YES TYPE HEATER: KEYSPAN AIRCONDITIONING: YES
TYPE HEAT: KEYSPAN WARM AIR: HOTWATER: X
OTHER: PANTRY OFF KITCHEN WITH WASHER/DRYER
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST_: STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST.:
OTHER:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION I DESCRIPTION I ART. I SEC.
REMARKS: BP9445 COZ34844, BP30973 COZ34847
INSPECTED BY: DATE ON INSPECTION: 02/23/11
GARY FI TIME START: 12:15PM END: 12:45PM
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
1. Final survey of property with accurate location of all buildings,property lines,streets,and unusual natural or
topographic features.
2. Final Approval from Health Dept.of water supply and sewerage-disposal(S-9 form).
3. .Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2110 of 1%lead.
5. Commercial building,industrial building,multiple residences and similar buildings and installations,a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit'Planning Board Approval of completed site plan requirements.
R. For existing buildings(prior to April 9, 1957) non-conforming uses,or buildings and"pre-existing"land.uses:
1. Accurate survey of property showing all property lines,streets,building and unusual natural or topographic
features.
2. ' A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing io the applicant.
C. Fees
1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00, Alterations to dwelling$50.00,
Swimming pool$50.00,Accessory. building$50.00,Additions to accessory building$50.00, Businesses$50.00.
2. Certificate of Occupancy on Pre-existing Building $100.00
3. Copy of Certificate of Occupancy-$.25
-4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.00
Date. '
New Construction: Old or Pre-existing Building: !/ (check one)
Location of Property: )QP_,r AVE—
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section Block ,d- Lot
Subdivision Filed Map. Lot:
Permit No. - Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ f3 O , dQ
Annli�ant C; n,r, ,-o
LOCATION:
(number & street) (municipality)
SUBDIVISION: MAP NO.: LOT(S):
NAME OF OWNER(S):
OCCUPANCY:
(type) (owner-tenant)
ADMITTED BY: ACCOMPANIED BY:
KEY AVAILABLE: SUFF. CO. TAX MAP NO. 1000-
SOURCE OF REQUE DATE:
bc�
D ELLING:
T E OF CONSTRUCTION: #STORIES:,0T.2— #EXITS:
FO NDATION: �_ CELLAR:FQ a CRAWL SPACE:10
TO L ROOMS: 1ST FLR: 1 2ND FLR: 3RD FLR:
BATH OOM(S): TOILET ROOM(S): U11LITY ROOM:
PORCH d ECK,TYPE: , q _ A"�'I0, TYPE:
BREEZEWAY: IREPLACE: . r9at�, GARAGE: 02' 776
DOMESTIC HO WA TYPE HEATER: AIRCONDITIONING:
TYPE HEAD WARM AIR: HOTWATER:
OTHER: �.
ACCESSORY STRUCTURES:
GARAGE, TYPE'OF CONST.: STORAGE, TYPE CONST.:
SWIMMING POOL: GUEST, TYPE CONST:
OTHER:
VIOLATIONS: CHAPTER 144 &N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATION DESCRIPTION ART. SEC.
REMARKS:
INSPECTED BY: DATE OF INSPECTION:
TIME START: AS END: %
(�. CONSENT TO INSPECTION
the undersi do es hereby state•
Owner(s)Name(s) .
do(es) y
That the undersigned(is) (are)the owner(s).of-the premises in the Town of
Southold, located at /D .�Lr,�y � .. �
which is.shown and'designated on the Suffolk County Tax Map as District 1000'
Section ,Block , Lot
That the.undersigned (has)(have)filed, or cause to-be filed, an application in the
Southold Town Building Inspector's Office for-the following:
° That the undersigned does)hereby give.consent to the Building Inspectors of the-
Town of Southold to-enter upon the'above described property, including any and all
buildings located thereon,.to conduct such.inspections,as.they may deem necessary with
respect to the aforesaid application, including inspections to.determine that said premises
complywith-'all-of the laws, ordinances; rules and regulations-of the Town of Southold.
The undersigned, in oonsentiiig to such inspections,•&(es) so with-the knowledge
and understanding that any information obtained.in the.conduct of such inspections may
be used in-subsequent prosecutions.for violations of the laws,ordinances,rules or '
regulations.of the Town of Southold:
Dated:
(Sigua e)
(Print Name)
(Signature)
(Print Name) .
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER- STREET V LLAGE DIST. SUB. LOT
FORMEh OWNER E ACR.
fi'DD
S0 yW TYPE OF BUILDING
o c E 'w Z,ZL S I i<ylo s7r. w.,1.
SEAS. VL. FARM COMM. CB. MICS. Mkt.Value.
LAND IMP: TOTAL DATE REMARKS
" 1-/OQ
rj o 0 3.F nv �300 F /a / 6 8�P- %'`, '99TS4 Bull P4 C lr
p. FER, �S�/yS IPfmov6 GR R•4,BLD.Nt"w .�i R t C ���
e, S
AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per .Value
Acre :-
Tillable FRONTAGE ON WATER
Woodland FRONTAGE ON ROAD
Meadowland DEPTH d
House Plot r BULKHEAD
w
Total DOCK
i
r .,N
v�,a
.:., COLOk. TRIM w r-+�rF
I
i
M. Bldg. S a 6e = 6 a u
Extension r R .2 3 = o oAy
Extension
Iq /a - Al
Extension fop pLl
Foundation G a yG F t Bath Dinette
Porch °SE a �p j Basement Floors P�y K.
Parch txt.Walls �V,Shj y? Interior Finish LR.
Breezeway Fire Place Heat 5 DR.
Garage y(� S74 Type Roof Rooms Ist Floor BR.
P**io 12- a z 7 6 Recreation Room Rooms 2nd Floor FIN. B
O. B. F N c Dormer Driveway
Total 6
NEW SUFFOLK AVENUE
0
4 o. o.; e e e 4 0 ,• .o
EDGE OF PAVEMENT—, m• Y
OVERHEAD WIRES UTILITY POLE� a .
N 88°29'00" E LIL #9 ° 100.00' TIE=277.58'
4. CONC
CONC. SIDEWALK 9 e 4 MON
_
SLIT RAIL
PIPE FENCE
FOUND y °. r^I 4• 3 (I e " L
0 0 o O LO
U f I a m _;
WOOD STOOP 4 ° e
M • 4 �
& STEPS 22 4'
24.3'
M ril 3 in
z i o0
N N N FRAME N
m GARAGE
AIR CONDITIONER
UNIT
3'1.10.9' 5.1
4.7' '
c 25.2' ROOF OVER
N W(OOD DECK m
y¢c STEPS
4.3' 1 STORY FRAME HOUSE
M
coN 12.2' 5.8'
22.7' CONC.
11.0' APRON
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Z WOOD DECK 3
o 03
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16.3' N U O
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SEPTIC
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CESSPOOLS (2) 0.4 SURVEY OF PROPERTY
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SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000- 1 14- 12- 16. 1
3 SCALE 1 "=20'
Y JANUARY 31 , 2011
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CERTIFIED TO:
CAROL RAFFE
FIDELITY NATIONAL TITLE INSURANCE COMPANY
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N O Q \ PREPARED IN ACCORDANCE WITH THE MINIMUM
N d O STANDARDS FOR TITLE SURVEYS AS ESTABLISHED
BY THE L.tY� APPROVED
0) �NO• �0�,1 FFOR SU HI USE BYNTHE NEW-=R NDTATE ADOPAND
V oI f 1' TITLE ASSOCIATION. f
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FO�NO �„��
`7 N.Y.S. Lic. No. 50467
UNAUTHORIZED ALTERATION ADDITION Nathan T of t r � I I I
�o TO THIS SURVEY IS A VIOLATION OF
y SECTION 7209 OF THE NEW YORK STATE
EDUCATION LAW. LSurveyor
� 9 Z � O � THE F THIS SURVEY MAP NOT RING
ELANDSURVEYORSINKED SEAL OR
b 0 O EMBOSSED SEAL SHALL NOT BE CONSIDERED —
�� TO BE A VALID TRUE COPY.
CERTIFICATIONS INDICATED HEREON SHALL RUN Successor To: Stanley J. Isoksen, Jr. L.S.
ONLY TO THE PERSON FOR WHOM THE SURVEY Joseph A. Ingegno L.S.
J IS PREPARED, AND ON HIS BEHALF TO THE
�� C) TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys — Subdivisions — Site Plans — Construction Layout
LENDING INSTITUTION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTI- PHONE (631)727-2090 FOX (631)727-1727
TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE.
THE EXISTENCE OF RIGHT OF WAYS OFFICES LOCATED AT MAILING ADDRESS
AND/OR EASEMENTS OF RECORD, IF 1586 Main Road P.O. Box 16
ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947
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